Patellofemoral Syndrome?

A couple of weeks ago I started getting some pain in the right knee. I tried riding on it but got a lot of pain when standing up. Sharp and quite painful. So I've now been off the bike for about two weeks. This syndrome has been mentioned as a possible cause. It hurts going up and down stairs and all seems to fit my symptoms. I think this all stems from my track training, seat hill climbs, pushing big gears. Being my first season, this was all reasonably new to a skinny whippet such as myself.

Does anyone have any experience of this syndrome or this type of pain?

Should I go to the doctor or will he just recommend rest?

After reading up, I think my options are:

• Strengthen the quadriceps muscles (vastus medialis obliquus)
  
• stop my knee moving in the down stroke
  
• stop seated hill climbing and buy a turbo!
  
  

Cheers

Rest won't sort out the underlying problem and self diagnosis and prognosis is risky when it comes to knees. I'd strongly recommend you see your GP. A good one will refer you to a physio, who can then treat this. I had something similar a few years ago and 4 sessions with the physio resolved it and I've not had any problems since.

You might want to think about getting custom insoles for your shoes too, somewhere like Cyclefit in Covent Garden can do this and I'd personally recommend it. They also use the Lemond Wedge system which aligns your foot with your knee to ensure your pedal stroke is aligned. This is also worth it in my experience.

I would first suggest - Rest.
Then, it can't hurt seeing someone trained to deal with sporting injuries like this. A normal GP is probably a waste of time.

I had this last year. It was caused by 3 things, all of which I sorted, rested up, and it stopped. Mine was caused by, pushing big gears without enough strengh in my legs, cleat angle on my shoes and excesive skidding.

I got stronger, sorted the cleat angle and stopped skidding.

Thanks guys. Despite similar reservations, I tihnk will go and see my GP just for a second opinion.

A lack of strength in my knees is a definite possibility, due to pushing much bigger gears than I'm used to. I don't skid hardly at all these days so OK on that front. But getting custom soles might be a good idea, I have wondered if my platform is a little off, so to speak.

On strengthening the knees and inner quads any suggestions on exercises?

Could it be this? http://www.itbs.info/ - also called "runners knee"

I had this at the start of the year and it really messed things up for me for nearly two months. Its where the tendon going from your hip to your knee shortens (because in cycling you never fully straighten your leg) and then then it pulls and rubs on you knee cap. Its reasonably common in runners and cyclists.

Same kind of symptoms - sharp pain when doing anything involving straightening your leg.

To cure it I had to rest off the bike (which took nearly a month to finally commit too), stretch the ITB (advice is on that website and others) and get the most painful sports massage imaginable to literally stretch the ITB having the physio by forcibly grate her thumbs along it (pillow biting stuff!)

Go see your GP about sharp knee pain. Really super sharp internal knee pain could be caused by meniscus tears or by loose cartiledge. Neither of those will sort themselves out by rest or by HTFU. I've had both knees go under the knife due to general wear and tear.

Not trying to scare the crap out of you, but your instict to see a GP is probably the right one.

We need to be careful here Elvis - because you don't want to get into any strengthening exercises just yet - before you get your knee looked at.
We use patellofrmoral syndrome as an "umbrella" term to diagnose the location of the injury. Numerous structures here could be the cause, due to either weakness or dominance.
A few tests need to be done to test the integrity of the structures, and to see the tracking of the kneecap, but it can't hurt to keep mobile, but maybe not on the bike (due to forceful extension on a flexed knee).
Get it looked at soon, so that "compensatory" movements are lessened. If i was down your way - i'd be more than happy....

I had knee pain earlier in the year. I was quite worried. I stopped riding, went to my Osteopath. He sorted me right out after a few sessions. Gave me loads of stretching exercises etc. It is completely fine now. Go back to him every month or so as a precautionary measure.

Serioulsy would not bother with going to the drs, most are useless. Find a good osteo/physio

Thanks guys. I think a mate down here knows a good physio I could use. But I think I better work out what it is before getting treatment.

And JC, thanks for that, I'll look into that website.

In my case, Elvis, my knee problems were just the first symptom that became really aggravated owing to general bad posture--but I actually have a long-standing hip problem, which apparently 'refers' stress to the knee. Because I'm astonishingly bad at locating specifically where pain occurs, I had never noticed this. I now do a (gentle) yoga course specifically for cyclists, which deals with all aspects of posture, and feel much better because of it. It may be that you sort out your problem with the kinds of specific interventions that the others mention, or it could be that a less localised approach to the problem(s) may be better for you. Good luck.

Anyone else suffering with this, had problems for the best part of 1.5 years on an off but haven't been riding anywhere like the same distances I was before. After a year of riding little and trying lots if solutions: bike fit, physio, exercises, ice, stretching thing still aren't back to normal I have decided to try and sort this out. After a visit to a very good Muscoskleteal podiatrist- Justin Coulter, the diagnosis is my extremely collapsed arches are to blame, custom innersoles, massage rollers on my ITB and yoga for core seem to be the way to go. If anyone is in need of some direction drop me a line.

Hmm, I hope you went back to your fitter to tell then that their fix hadn't worked? A fitter should have looked at your feet and made sure that the arches are sufficiently well supported in your cycling shoes so that your lower leg isn't twisting with every stroke.

Hi,
In my case (Flat feet custom insoles) two issues usually raise their ugly heads. If it is ITB (outside the knee) get a foam roll and check google for self myofacial release. The sweet spot is outside the tight about in the middle. the tighter it is the longer the sore area. the roll hurts like h€// but works. If it is inside and slightly below it is sartorius. Stretcing will help. So does the foam roll. I've relized that heavy lifting and hard biking do call for some maintenance. The older I get the more I need to pay attention to those things.